Abstract

Cryptococcus neoformans (Cn) is a significant human pathogen that, despite current treatments, continues to have a high morbidity rate especially in sub-Saharan Africa. The need for more tolerable and specific therapies has been clearly shown. In the search for novel drug targets, the gene for glucosylceramide synthase (GCS1) was deleted in Cn, resulting in a strain (Δgcs1) that does not produce glucosylceramide (GlcCer) and is avirulent in mouse models of infection. To understand the biology behind the connection between virulence and GlcCer, the production and localization of GlcCer must be characterized in conditions that are prohibitive to the growth of Δgcs1 (neutral pH and high CO2). These prohibitive conditions are physiologically similar to those found in the extracellular spaces of the lung during infection. Here, using immunofluorescence, we have shown that GlcCer localization to the cell surface is significantly increased during growth in these conditions and during infection. We further seek to exploit this localization by treatment with Cerezyme (Cz), a recombinant enzyme that metabolizes GlcCer, as a potential treatment for Cn. Cz treatment was found to reduce the amount of GlcCer in vitro, in cultures, and in Cn cells inhabiting the mouse lung. Treatment with Cz induced a membrane integrity defect in wild type Cn cells similar to Δgcs1. Cz treatment also reduced the in vitro growth of Cn in a dose and condition dependent manner. Finally, Cz treatment was shown to have a protective effect on survival in mice infected with Cn. Taken together, these studies have established the legitimacy of targeting the GlcCer and other related sphingolipid systems in the development of novel therapeutics.

Highlights

  • Cryptococcus neoformans (Cn) is one of the major fungal human pathogens and continues to have clinical significance despite the development of antifungal drugs

  • The Center of Disease Control and Prevention (CDC) estimates that over 1 million new cases/year of cryptococcosis are reported worldwide in patients with acquired immune deficiency syndrome (AIDS), with over half those affected dying of the infection, making deaths caused by cryptococcosis in patients with HIV in sub-Saharan Africa more frequent than deaths caused by tuberculosis [3,4]

  • Production of IgM monoclonal antibodies against Cn GlcCer

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Summary

Introduction

Cryptococcus neoformans (Cn) is one of the major fungal human pathogens and continues to have clinical significance despite the development of antifungal drugs. Cn acts as a facultative intracellular pathogen, growing in either the extracellular spaces of the alveoli or intracellularly in the acidic phagolysosome of the alveolar macrophages In some patients, this infection progresses, disseminating to the bloodstream where it can cause infections in most major organ systems. The Center of Disease Control and Prevention (CDC) estimates that over 1 million new cases/year of cryptococcosis are reported worldwide in patients with acquired immune deficiency syndrome (AIDS), with over half those affected dying of the infection, making deaths caused by cryptococcosis in patients with HIV in sub-Saharan Africa more frequent than deaths caused by tuberculosis [3,4].

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